Neuropsychological profile and vascular risk factors in patients with cerebral microangiopathy

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Abstract

Introduction. Cerebral microangiopathy (CMA) is one of the leading causes of cognitive impairment (CI). Recently proposed international standards for MRI diagnosis of SVD in aging and neurodegeneration (STRIVE, 2013) are aimed at standardization of SVD research.

Objective: to clarify the severity and structure of CI and their relationships with vascular risk factors in SVD diagnosed with the STRIVE criteria.

Material and methods: Ninety-six patients with with SVD and cognitive complaints (31 men and 65 women, mean age 61.0 ± 6.6 years) were exmanied. The severity of CI was assessed with the MoCA scale: patients with MoCA<26 points who were independent in their daily life were graded as having mild CI (MCI), and those who was dependent were graded as having dementia; in patients with MoCA≥26, the assessment of separate cognitive functions (CF) was made. The type of CI was determined according to isolated or predominantly impaired CF, and in case of equal impairment of several CFs the type was cassifide as mixed. Impairment of CF was assessed by a deviation from the normal test parameters: >1.5σ, mild and >2,5σ, severe.

Results. The severity structure of CI was as follows: dementia, 15.5%, MCI, 66.7% and subjective CI, 17.7%. Neuropsychological profile of MCI included: isolated (21.3%) and predominantly (24.3%) executive dysfunction, predominantly amnestic dysfunction (28.3%), and mixed dysfunction (26.1%); in dementia we observed mixed dysfunction (80%), predominantly executive dysfunction (13.3%) and predominantly amnestic dysfunction (6.7%). A tendency to increase in the CI severity with age was revealed. Among the risk factors, only grade 3 arterial hypertension was significant for the development of dementia.

Conclusions: Dementia in SVD patients aged 46–69 is characterized by mainly mixed profile of CI and associated with grade 3 arterial hypertension. MCI is characterized by variability of the CI types and the lack of a clear link with vascular risk factors, which justifies the need for clarifying the causes and risk factors of SVD and mechanisms of the development of CI.

About the authors

Larisa A. Dobrynina

Research Center of Neurology

Email: gadjieva@neurology.ru
ORCID iD: 0000-0001-9929-2725

D. Sci. (Med.), Head, 3rd Neurology department

Russian Federation, Moscow

Zukhra Sh. Gadzhieva

Research Center of Neurology

Author for correspondence.
Email: gadjieva@neurology.ru
Russian Federation, Moscow

Lyudmila A. Kalashnikova

Research Center of Neurology

Email: gadjieva@neurology.ru
Russian Federation, Moscow

Bulat M. Akhmetzyanov

Research Center of Neurology

Email: gadjieva@neurology.ru
Russian Federation, Moscow

Elena I. Kremneva

Research Center of Neurology

Email: gadjieva@neurology.ru
Russian Federation, Moscow

Marina V. Krotenkova

Research Center of Neurology

Email: gadjieva@neurology.ru
ORCID iD: 0000-0003-3820-4554

D. Sci. (Med.), Head, Neuroradiology department

Russian Federation, 125367 Moscow, Volokolamskoye shosse, 80

Dmitry Yu. Lagoda

Research Center of Neurology

Email: gadjieva@neurology.ru
ORCID iD: 0000-0002-9267-8315

junior researcher, Department of neurorehabilitation and physiotherapy

Russian Federation, Moscow

Maryam R. Zabitova

Research Center of Neurology

Email: gadjieva@neurology.ru
Russian Federation, Moscow

Anna A. Poddubskaya

N.N. Burdenko National Medical Research Center of Neurosurgery

Email: gadjieva@neurology.ru
ORCID iD: 0000-0002-5776-3442

neuropsychologist, neurologist, Group of functional neurosurgery

Russian Federation, Moscow

Alexandr B. Berdalin

M.V. Lomonosov Moscow State University

Email: gadjieva@neurology.ru
Russian Federation, Moscow

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Copyright (c) 2018 Dobrynina L.A., Gadzhieva Z.S., Kalashnikova L.A., Akhmetzyanov B.M., Kremneva E.I., Krotenkova M.V., Lagoda D.Y., Zabitova M.R., Poddubskaya A.A., Berdalin A.B.

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